Summary
A letter in The BMJ argues that recurrent missed appointments should prompt clinicians to consider possible undiagnosed or inadequately treated ADHD. It presents this as one possibility alongside wider circumstances that can affect engagement with care.
A letter published in The BMJ on 22 September 2026 argues that recurrently missing healthcare appointments should prompt clinicians to consider possible undiagnosed or inadequately treated attention deficit/hyperactivity disorder (ADHD). The author, consultant psychiatrist and visiting researcher Ulrich Müller-Sedgwick, presents ADHD as one possible explanation—not as a conclusion that can be drawn from attendance alone.
Why the letter raises ADHD
Müller-Sedgwick responds to a discussion of missed appointments that encourages clinicians to look beyond assumptions about patients’ motivation and consider circumstances that can make it harder to engage with healthcare. He adds that difficulties associated with ADHD may also be relevant.
The letter points to challenges with organisation, time management, prospective memory—the ability to remember to carry out a planned action—prioritisation and planning. These are offered as reasons to consider ADHD when missed appointments recur. The argument is that attendance patterns may be a useful prompt for clinical consideration, rather than a basis for judging a patient’s motivation.
A prompt to consider, not a diagnosis
The BMJ item is a clinical letter advancing a viewpoint, not a study measuring how often missed appointments are associated with ADHD or testing an appointment-based screening method. Its central point is therefore about what clinicians might consider when a pattern of missed visits emerges.
The letter places that consideration alongside the wider circumstances that can affect healthcare engagement. Repeatedly missing appointments, by itself, does not identify the reason. The author’s suggestion is to include possible ADHD among the explanations considered in an appropriate clinical context.